RATIONALE: Drugs used in chemotherapy, such as ixabepilone, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing or by stopping them from spreading. Vorinostat may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Giving ixabepilone together with vorinostat may kill more tumor cells. PURPOSE: This randomized phase I trial is studying the side effects, best way to give, and best dose of vorinostat when given together with ixabepilone in treating patients with breast cancer that has spread to another place in the body.
PRIMARY OBJECTIVES: I. To determine the safety and tolerability of the combination of vorinostat with ixabepilone. II. To determine the best schedule for delivery of this drug combination. III. To recommend a phase II dose of vorinostat in combination with ixabepilone. SECONDARY OBJECTIVES: I. To determine the objective response rate and/or clinical benefit rate. II. To assess the toxicity profile. TERTIARY OBJECTIVES: I. Collecting circulating tumor cells pre and post-treatment to study its deoxyribonucleic acid (DNA) somatic mutation and methylation assay after the introduction of histone deacetylases (HDAC) inhibitors and ixabepilone. II. To determine whether administration of vorinostat with ixabepilone will alter the pharmacokinetics of vorinostat. OUTLINE: This is a phase I, dose-escalation study of vorinostat. Patients are randomized to 1 of 2 treatment arms. Arm I (Cohort A): Patients receive oral vorinostat once daily on days 1-14 and ixabepilone intravenously (IV) over 3 hours on day 2. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity. Arm II (Cohort B): Patients receive oral vorinostat once daily on days 1-7 and 15-21. Patients also receive ixabepilone IV over 3 hours on days 2, 9, and 16. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity. After completion of study treatment, patients are followed periodically.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
56
City of Hope
Duarte, California, United States
South Pasadena Cancer Center
South Pasadena, California, United States
Dose limiting toxicity defined as any treatment-related grade 3 or greater non-hematologic toxicity, grade 4 febrile neutropenia, thrombocytopenia or grade 4 neutropenia as a result of unresolved toxicity
Graded according to the National Cancer Institute (NCI) CTCAE version 4.0. DLT is defined for each dose level and will include both drugs ixabepilone and vorinostat.
Time frame: Cohort A evaluated every 3 weeks during treatment, Cohort B every 4 weeks during treatment.
Objective response rate and/or clinical benefit rate
Time frame: Cohort A evaluated every 6 weeks, Cohort B evaluated every 8 weeks until progression of disease.
Toxicity profile
Time frame: Cohort A every 3 weeks during treatment, Cohort B every 4 weeks during treatment.
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.